CMS Price Transparency Data

CT scan, sinuses

Facility: Memorial Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $354
  • Cash Discount Price: $787
  • vs. Medicare Baseline: 3.31x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Memorial Medical Center is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $787. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.31x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$787

Average discount available for prompt cash payment at this facility.

Insurance Median
$354

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $787 (737%)
Insurance Median: $354 (331%)
Cash: $787 (737% of Medicare)
Ins. Median: $354 (331% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 331% of the Medicare baseline (a markup of 231%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Triwest Va Pccc-All Plans $38 - $564 36%
Amerigroup Mcr Adv-All Other Plans $39 - $575 37%
Care Improvement Plus - All Other Plans $39 - $575 37%
Care Improvement Plus Mcr $39 - $581 37%
Superior Allwell Mcr Adv-All Other Plans $39 - $575 37%
UnitedHealthcare $39 - $1,643 37%
Universal American Mcr-All Other Plans $39 - $575 37%
Universal American Snp $41 - $604 38%
Coventry First Hlth Hmo Ppo-All Other Plans $49 - $1,643 46%
Coventry First Hlth Mcr Adv $49 - $575 46%
Galaxy Health Network-All Plans $57 - $1,746 53%
Ambetter / Centene $62 - $690 58%
Capstar Health Network-All Plans $80 - $1,643 75%
Cigna $80 - $1,540 75%
Healthcare Highways-All Plans $126 - $1,643 118%
Prime Healthcare Services-All Plans $136 - $1,438 127%
Blue Cross Blue Shield $146 - $384 137%
Humana $156 - $1,643 146%
Corvel Work Comp-All Plans $165 - $1,746 154%
Independent Med Sys Ppo-All Plans $165 - $1,746 154%
Multiplan Mcr Adv $165 - $575 154%
Multiplan Phcs Ppo-All Other Plans $165 - $1,746 154%
Provider Select Ppo-All Plans $165 - $1,746 154%
Three Rivers Ppo-All Plans $165 - $1,746 154%
Usa Mso - All Plans $165 - $1,746 154%
Amerigroup Chip $195 - $986 183%
Amerigroup Star $195 - $986 183%
Amerigroup Star Kids $195 - $986 183%
Amerigroup Star Plus $195 - $986 183%
Comm Health Chip $195 - $986 183%
Comm Health Perinatal-All Other Plans $195 - $986 183%
Molina Chip/Star-All Plans $195 - $986 183%
Scott & White Chip/Star-All Plans $195 - $986 183%
Superior Chip/Star $195 - $986 183%
Texas Childrens Hp - All Plans $195 - $986 183%
Comm Health Mcaid Hmo $204 - $1,035 191%
Comm Health Star $204 - $1,035 191%
Aetna $1,643 1538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals